Rising temperatures in India are pushing those who have to be outdoors to adapt to a new reality

Unprecedented temperatures have struck large parts of northern and central India for weeks, killing dozens of people and unleashing a public health crisis.

The World

In New Delhi, rickshaws are a convenient and affordable mode of transport through the city’s crowded roads. But these days, the small three-wheeled vehicles — which are shaded but open from both sides — allow for blasts of hot air to lash passengers in the face as they barrel down the street. 

It can feel like you’re sitting in front of a furnace, barely able to keep your eyes open.

Large swaths of northern and central India have been sizzling under scorching heat for several weeks. In late May, temperatures shot up to 122 degrees Fahrenheit in many states and the capital, New Delhi. Coinciding with India’s general election, the relentless heat unleashed a public health crisis, killing 56 people.

An auto-rickshaw driver rests in his vehicle parked under the shade of a tree on a hot summer day in Ahmedabad, India, June 7, 2024.Ajit Solanki/AP

No escape for some

For those who have to be outdoors — like construction workers, vendors and farmers — there is no escape from the heat. Zayed Ali, who works for an internet provider and goes door-to-door to make sales calls, steps out at 8:30 a.m., fully prepared. He said he wears gloves and wraps his head with a cloth under his motorbike helmet.

“I spend the whole day outside, and I am always drenched in sweat,” he said.

He strives to be well-hydrated throughout the day, he added, asking every customer for water and finishing the entire bottle. Headaches and dizziness have become normal for him, and the only relief he gets is at lunchtime when he’s able to sit in the shade.

Intense weather

A group of rickshaw drivers waiting on a sidewalk in Delhi said they have no choice but to work in the heat. Plus, they said the heat this year has been more intense than anything they’ve experienced before.

A tea vendor sits under a large umbrella with a cotton towel on his head to beat the Delhi heat.Sushmita Pathak/The World

“It is much more severe,” confirmed Avikal Somvanshi, a researcher at the Center for Science and Environment in Delhi. “In fact, of the 24 year-data that I have analyzed so far, this is the worst.”

A striking component of this year’s heat wave has been elevated nighttime temperatures, Somvanshi explained. Many cities, including Delhi, are seeing unusually warm nights, which is a cause of concern.

“Your body and all the systems don’t really get a chance to rest and recoup so that they can be ready to face the heat again the next day,” Somvanshi said. “And that is a very dangerous thing from a health perspective.”

Then there’s the high humidity, which interferes with sweating — the body’s natural cooling mechanism. , Somvanshi said that humidity levels across Delhi and the northern plains have been steadily rising over the years.

High casualties

Dr. Seema Wasnik is the head of the recently opened heat stroke unit at Delhi’s Ram Manohar Lohia Hospital. She says that rapidly cooling the patient is key in heat stroke cases and can significantly bring down mortality.Sushmita Pathak/The World

According to Somvanshi, the high number of casualties this year can also be partially attributed to the elections. “People were forced to come out and participate in, not just voting, but also … campaigning and rallies.”

In the northern Indian state of Uttar Pradesh, 33 polling staff succumbed to extreme heat on a single day. The heat may have also put a damper on voter turnout, which, in Delhi, was the lowest in a decade

Across the country, there have been some 25,000 suspected cases of heatstroke so far. To cope with the ongoing public health crisis, Delhi’s Dr. Ram Manohar Lohia Hospital opened a dedicated heatstroke unit last month, the first in the city. 

The unit — part of the hospital’s emergency department — is equipped with two large tubs where patients are immersed in icy water to bring their body temperature down. 

“You have to start rapidly cooling the patient. The sooner, the better,” said Dr. Seema Wasnik, the head of the unit. “If you rinse the patient in ice-cold water, the temperature comes down [within] 30 to 40 minutes, and mortality goes down from 80% to 10%.”

Tubs at the Ram Manohar Lohia Hospital in New Delhi allow for patients to be immersed in ice water to reduce their body temperatures and the risk of heatstroke.Sushmita Pathak/The World

“You have to start rapidly cooling the patient, the sooner the better.”

Dr. Seema Wasnik, head of heatstroke unit, Dr. Ram Manohar Lohia Hospital

The special unit also has an ICU bed fitted with an inflatable tub, which resembles a kiddie pool. That way, doctors don’t have to take the patient off the ventilator to start the cooling process, Wasnik explained.

A special ICU bed fitted with an inflatable tub ensures that critical patients need not be taken off the ventilator to start the cooling process.Sushmita Pathak/The World

Ambulances have also been fitted with tubs and ice boxes to save valuable time. “Right at the place where this casualty has happened, we can start cooling the patient then and there,” she added.

The heatstroke unit at Delhi Ram Manohar Lohia Hospital is equipped with two tubs where patients can be immersed in icy water to bring their temperature down quickly.Sushmita Pathak/The World

As in any medical emergency, time is of the essence. In heatstroke cases, delays can cause organ failure, Wasnik said. These measures are relatively inexpensive and can be adapted by hospitals everywhere, she added. “Because of global climate change, these things are going to become more severe over the years to come.”

Longer heat waves

India’s summers have always been uncomfortably hot, but “what climate change is doing [is] that these heat waves are becoming more frequent and more elongated,” researcher Somvanshi said.

Sadly, the unrelenting bouts of heat are here to stay. “Even if we are successful at stabilizing global warming at 1.5 degrees Celsius, the heat waves will continue to grow and get more intense,” Somvanshi said. He added that they are now a permanent fixture of life that we have to get used to.

It’s a grim idea, and Zayed Ali, the Wi-Fi salesman, is learning to live with it because he has to. “I have a job to do, a family to feed. So, I will tolerate the heat,” he said. 

Meanwhile, Delhi is expected to get some much-needed relief around the end of June when the monsoon finally arrives.

Related: What it takes to pull off the world’s largest election in India

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